Hepatitis C antibody test
Facility: Kiowa District Hospital
Billing Code: 86803 (CPT)
- CPT Billing Code: 86803
- Insurance Median: $84
- Cash Discount Price: $71
- vs. Medicare Baseline: 5.89x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $14.27 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 589% of the Medicare baseline (a markup of 489%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Healthchoice-All Plans | $21 | 147% |
| Tricare | $35 | 245% |
| Blue Cross Blue Shield | $45 | 315% |
| UnitedHealthcare | $71 - $89 | 498% |
| Health Partners Of Ks-All Plans | $78 | 547% |
| Humana | $80 | 561% |
| Multiplan-All Plans | $84 | 589% |
| Gbs Insurance - All Plans | $84 | 589% |
| Medicare (plans) | $85 | 596% |
| Triwest-All Plans | $85 | 596% |
| Aetna | $85 | 596% |
| Medicaid / KanCare | $89 | 624% |
| Providers Care (Wppa)-All Plans | $134 | 939% |
| Liberty Healthshare-All Plans | $144 | 1009% |
Consumer Guidance & Cost Commentary
For this Hepatitis C antibody test at Kiowa District Hospital, the cash price of $71.00 is lower than the facility's negotiated rates, which average $84.00 across 14 payers. While the cash rate is notably lower than the gross charge of $89.00, patients with high-deductible plans may find that paying out-of-pocket is more cost-effective than relying on insurance, as the negotiated rates often exceed the cash price. It is important to note that while the facility is a Critical Access Hospital in Kansas, specific county or state average data was not provided in this report, so comparisons to regional benchmarks are not available.
Patients should be aware that commercial insurance rates can sometimes be higher than cash prices due to administrative costs and contract dynamics, even though they offer coverage. If you choose to use insurance, you may encounter balance billing if services are rendered by out-of-network providers, though the No Surprises Act protects you from such bills for emergency care and non-emergency services at in-network facilities. To ensure you receive the best possible rate, we recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. Additionally, if you receive a bill, request a detailed itemized statement to verify that all charges are accurate and that no unbundled codes or services not rendered have been included.